In September I wrote a blog, “Ending Affordable Care Act Tax Credits Would Devastate Older Adults,” detailing the impact on older adults if Congress let the Enhanced Premium Tax Credits (EPTC) associated with the Affordable Care Act (ACA) expire at year’s end. Well, it’s 2026 and Congress still hasn’t reached an agreement.

Let’s Examine Where We Left Off in 2025

In 2025, the Center for Medicare and Medicaid Services (CMS) reports about 24 million people signed up for insurance through the ACA. According to the Bipartisan Policy Center, 24% of people enrolled were over 55. In addition, AARP reports, “The uninsured rate among adults ages 50 to 64 fell 50% between 2012 and 2023, from 14.5% to 7.3%. Availability of federal premium tax credits and tax credit enhancements have played a key role in increasing coverage.”

Sadly, expired EPTC have now caused the rate of insurance coverage to decline. More expensive coverage has caused people to drop insurance or get plans with less coverage. The Center for Medicare and Medicaid Services reports that signups for Affordable Care Act benefits are down by 800,000 compared to last year. Furthermore, AARP reported in April 2025, “Nearly 5 million midlife adults ages 50 to 64 will face higher premiums in 2026 for private insurance through state and federal health insurance Marketplaces.”

In addition, people have chosen ACA plans which are more economical and provide less coverage. California reports 33% of people are covered by an ACA bronze plan, compared to 20 percent last year. Bronze plans are the most economical but have high deductibles compared to other ACA plans.

People Behind the Numbers

This dramatic drop in health insurance coverage is more than statistics; we need to remember the faces behind the numbers.

AARP reported on Brad Korb, 59-years-old and from Huntsville, Alabama. Korb worked 30 years for Boeing as an engineer. In 2021, he turned to the ACA marketplace to find insurance. In 2025, Korb was paying $338 per month for health insurance, which included savings of $480 a month because of the Enhanced Premium Tax Credits.

In 2026, with no EPTC, the policy skyrocketed to $966 a month. Due to the astronomical cost, Korb considered going without insurance. But he decided to remain insured. Korb last year was admitted into the hospital and was billed $30,000 for a 24-hour stay. Thanks to his insurance, he had to pay only $4,000 of the $30,000 in charges. Couple that with being on prescription medication, and Korb decided to keep his insurance, despite the high monthly price tag. Unfortunately, to pay for insurance he is dipping into his savings.

As stated in my previous article, older adults with insurance generally have healthier outcomes. A recent Leadership Council of Aging Organizations letter to congressional leaders cited JAMA Health Forum and stated, “Data has shown older adults entering Medicare after access to marketplace coverage have had fewer hospitalizations, less medication use for chronic disease, and lower out-of-pocket costs, as well as fewer limitations in activities of daily living.”

In December, Time magazine reported that tax credit subsidies helped the uninsured rate for people 50 to 64 to drop by 50%.

What’s Next

As of today, Congress still has not passed legislation to extend the enhanced subsidies. The impact has real life consequences for millions of people, including older adults. There are countless people like Korb who are feeling the burden of increasing health insurance costs. Congress shouldn’t stop negotiating on this issue. Nobody in this country should be forced to ask themselves, “Does it make more sense for me not to have health insurance?”

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Evan Carmen, Esq. is the Legislative Director for Aging Policy at the B’nai B’rith International Center for Senior Services. Click here to read more from Evan Carmen.